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Editorials
Friday, November 24, 2000Dental clinic
closure is
devastating
for stateThe issue: Federal budget cuts have caused Queen's Medical Center to plan the shutdown of an important dental facility.
HAWAII'S isolation has diminished over the years with advances in technology and air transportation, but medical and dental care cannot be delivered from afar. The announcement by Queen's Medical Center that it soon will shut down the state's only clinic providing dental services to poor and severely ill patients requires prompt action to prevent the closure. Congressional action may be needed to provide funds to assist in this insular emergency.
For 40 years, a clinic underneath the old emergency room at Queen's has been used to provide dental services to people with major illnesses such as heart problems or cancer, or to those requiring hospital treatment of such maladies as infections, oral trauma and surgery. About 4,000 patients a year receive treatment by the clinic's staff of eight. As noted by the Star-Bulletin's Tim Ruel, the clinic also has been Hawaii's only residency program to train dentists in critical care.
Queen's plan to close the clinic is part of the hospital's latest cutbacks after reductions in federal reimbursement for Medicare and Medicaid patients. The medical center has been forced to eliminate 460 jobs over the past four years. It recently dropped its cardiac rehabilitation unit.
In 1997, Congress slashed $250 billion in Medicare and Medicaid reimbursements to hospitals nationwide through 2002. The federal budget cuts caused Queen's, which had been running in the black for much of the last decade, to begin losing money. It ran up a $10 million operating deficit for the fiscal year that ended in June. The dental clinic loses $350,000 a year.
"We've got a problem now with those individuals who have special needs -- who require hospitalized dentistry," said state Health Director Bruce Anderson. "Frankly, there are no easy alternatives."
The state operates four dental clinics serving the poor, and community centers run three. Treatment of severe dental fractures will remain available for those who can afford it. However, only a half dozen dentists in the state are qualified to treat patients with severe mental or physical illness. Mark Greer, the state's chief dental officer, says that isn't enough.
Medicare and Medicaid cuts nationwide leave mainland residents with options that are unavailable to island residents because of lack of proximity to care facilities.
Hawaii's congressional delegation should seek recognition of that problem in the form of budgetary considerations to assure residents adequate medical and dental care.
Russian arms
to Iran merits
U.S. sanctions
RUSSIA has threatened to recant its pledge to curb sales of tanks and battlefield weapons to Iran. Economic sanctions would be an appropriate rejoinder by the United States, a prospect that Russia can ill afford.
The agreement to bring all arms sales to Iran to a close by the end of 1999 and not enter into new contracts was made in 1995 by then-Russian Prime Minister Viktor Chernomyrdin and the Clinton administration, and was supposed to be confidential. However, when Vice President Al Gore came under criticism from Republicans in his presidential campaign for acquiescing in arms sales to Iran, Democrats pointed to the Chernomyrdin agreement.
Russian Foreign Minister Igor Ivanov notified Secretary of State Madeleine Albright four days before the U.S. presidential election that Russia would no longer honor the pledge because the U.S. had violated its confidentiality. However, according to Washington Post columnist Jim Hoagland, who reported the latest development, U.S. officials speculate that Russia already was looking for a pretext to pursue new arms contracts with Iran.
Russia's threat to renew arms sales to Iran after Dec. 1 surfaced a day after China announced it would not help Iran or Pakistan develop ballistic missiles. The U.S. immediately responded by immediately waiving sanctions on Chinese companies suspected of having assisted Iran and Pakistan, even before China's promise has been implemented.
Rep. Benjamin A. Gilman, R-N.Y., chairman of the House International Relations Committee, called for immediate economic sanctions on Russia. "Such a misguided policy of acquiescence to Russian arms transfers has not been able to withstand public scrutiny and has now collapsed of its own weight," Gilman said.
Russia is still struggling to build a prosperous economy from the rubble of the Cold War and can hardly afford to cut off assistance from the West. A strong U.S. reaction may be needed to prompt Russian President Vladimir Putin to put Ivanov on a leash.
Published by Liberty Newspapers Limited PartnershipRupert E. Phillips, CEO
John M. Flanagan, Editor & Publisher
David Shapiro, Managing Editor
Diane Yukihiro Chang, Senior Editor & Editorial Page Editor
Frank Bridgewater & Michael Rovner, Assistant Managing Editors
A.A. Smyser, Contributing Editor
